Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: KEGG:D01311 (Metrizamide)
 591 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Metrizamide (Amipaque), a water soluble nonionic contrast medium has less toxic effect in comparison with other contrast media, and it is now widely used for myelography, cisternography, ventriculography and cerebrospinal fluid dynamic imaging. However, as the number of cases in which this medium has been utilized has gradually increased, incidents of toxic manifestations have been reported. Among these, there are a considerable number of case reports referring to metrizamide encephalopathy, but only a few authors reported the appearance of triphasic waves on EEG when they occurred. The authors experienced one case of metrizamide encephalopathy accompanied by frequent appearance of triphasic waves on EEG. A 31-year old male was admitted to our hospital with the complaint of right homonymous hemianopsia. At that time he was fully conscious and mentally alert. On CT, 39 mm X 45 mm partially enhanced isodense mass was revealed on the enlarged sella turcica. Laboratory findings showed high titer of prolactin (10200 ng/ml). Premedication of 100 mg phenobarbital i.m. was followed by the tomography of the sella turcica, using 8 ml of 250 mgI/ml metrizamide injected into L 3-L 4 subarachnoid space. Several hours after the examination, he complained of slight nausea and was kept in bed with his head placed in an elevated position. The next morning, he was found to be in a drowsy state. He was disoriented and could not respond adequately to questions asked. His naming of daily necessities was also poor, although he knew how to use them.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[A case of metrizamide encephalopathy with triphasic waves on EEG]. 654 77

We compared the effect of metrizamide and its parent compound glucosamine on the kinetics of dog brain hexokinase. The Michaelis constant (Km) for glucose rose from 0.065 to 0.15 to 0.28 mM in the presence of 0, 16, and 32 mM metrizamide, respectively. For 0, 1.5, and 3.7 mM glucosamine, the Km values were 0.065, 0.4, and 1.3 mM. No change was found in the maximal velocity with either inhibitor. Metrizamide is therefore a rather weak competitive inhibitor of brain hexokinase. However, since the brain or spinal cord may be exposed to metrizamide concentrations near 780 mM during myelography, it is predictable that glucose metabolism may be significantly impaired under these conditions. This may be the mechanism for some cases of metrizamide encephalopathy.
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PMID:Competitive inhibition of brain hexokinase by metrizamide. 719 50

A case of Iotrolan encephalopathy is reported. A 66-year-old woman, suffering from subarachnoid hemorrhage, was admitted to our department on January 17th, 1995. After an operation for aneurysmal clipping and ventriculo-peritoneal shunt, she was discharged with no neurological deficiency. CT scan revealed ventricular enlargement and slight periventricular lucency. She was re-admitted on January 4th, 1996. She was suffering from nausea, vomiting, right hemiparesis, right hemi-hypesthesia and disturbance of consciousness. CT scan demonstrated right thalamic bleeding and bilateral ventricular hemorrhage. Further ventricular enlargement was also revealed. With medical treatment, her symptoms were relieved gradually. But disorientation and memory disturbance continued. Shuntography with Iotrolan was performed on February 2nd, 1996. The ventriculo-peritoneal shunt was demonstrated to be occluded on the abdominal side. The volume of Iotrolan used was about 8cc. She became very restless on the night of the examination. Her temperature was up to 38. CT on February 4th demonstrated brain penetration of the Iotrolan. Revision of ventriculo-peritoneal shunt, administration of steroids and hydration was performed. CSF findings demonstrated no abnormalities. Her symptoms were relieved gradually. Iotrolan is a non-ionic contrast media of dimer type, composed of C37 H48 I6 N6 O18. Its distinctive features are low distributing coefficient and high affinity with water. Contrasting several reports of Metrizamide encephalopathy, only 2 cases of Iotrolan encephalopathy were reported. Iotrolan is reported to be much safer than Metrizamide. We were able to find brain penetration by Iotrolan. It is expected to be a characteristic radiological finding of encephalopathy induced by contrast media. The mechanism of Iotrolan encephalopathy is obscure. Several theories concerning Metrizamide encephalopathy are proposed. These are (1) inhibition of hexokinase, (2) inhibition of acethylcholinesterase, (3) immunological mechanism and (4) vascular disturbance. Iotrolan has no 2-deoxy-glucose structure. The inhibition theory of hexokinase is least expected. Related matters are circulatory disturbance of liquor, dehydration, excessive contrast media, advanced age, diabetes mellitus, hypertension, epileptic patients and patients taking phenothiazines. Prompt therapy is important. Removal of contrast media, hydration and administration of steroids should be performed as early as possible.
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PMID:[A case of Iotrolan encephalopathy]. 893 76